# DR JACK D MILLER LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Drs Miller and Miller
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821212416
- **Authorized official:** DR. JACK D MILLER JR. OD (OWNER)
- **Authorized official phone:** (337) 457-5277

## Contact information

- **Practice address:** 350 MOOSA BLVD, EUNICE, LA 70535-3626
- **Practice address phone:** (337) 457-5277
- **Practice address fax:** (337) 457-5271
- **Mailing address:** 350 MOOSA BLVD, EUNICE, LA 70535-3626
- **Mailing address phone:** (337) 457-5277
- **Mailing address fax:** (337) 457-5271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 941-084T | LA | Yes |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 04/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0289830001 | CIGNA GOVERMENT SERVICES | LA |
| 05 | — | 1340952 | — | LA |
| 01 | — | 2105B | BLUE CROSS BLUE SHIELDPIN | LA |